VA Form 10-0491D: HPSP & VIOMPSP Completion Notice

VA Form 10-0491D: HPSP & VIOMPSP Completion Notice – VA Form 10-0491D is a key document for recipients of the Health Professional Scholarship Program (HPSP) and the Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP). It serves as the official Education Program Completion Notice and facilitates Service Obligation Placement with the U.S. Department of Veterans Affairs.

This form helps VA track degree completion, licensure/certification, and assign scholarship recipients to positions that fulfill their service commitment at VA facilities. It is essential for transitioning from scholarship support to obligated employment.

What Is VA Form 10-0491D Used For?

VA Form 10-0491D notifies the VA of program completion and supports placement into a full-time clinical or direct patient care position. Recipients must submit it along with an official transcript showing the degree conferred and any relevant licensure or certification.

The form includes sections for:

  • Completion Information: Degree details and supporting documents.
  • Service Obligation Selection: Details if a position has been secured (including facility, position title, hiring official, and SF-50 when available).
  • Service Obligation Update: If no position has been selected yet, listing contacted facilities with no vacancies.

It applies to HPSP, VIOMPSP, and related programs like VHVMAESP. The form is revised as of February 2020 and remains current.

Download the official form here:
Download VA Form 10-0491D (PDF)

Understanding the Health Professional Scholarship Program (HPSP)

The HPSP provides full tuition, a monthly stipend, and an annual book allowance to students in health care disciplines. In return, recipients commit to a service obligation—typically a minimum of 2 years (or more, depending on the occupation and support duration) at a VA health care facility.

Eligible fields often include nursing, social work, psychology, pharmacy, and other high-need areas. Placement begins around 90 days after graduation or meeting qualification standards (licensure, credentialing).

VA Form 10-0491D plays a critical role in documenting completion and securing the obligated position.

Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP)

VIOMPSP supports students pursuing degrees or certificates in visual impairment and orientation/mobility specialties to address shortages in blind rehabilitation services for Veterans.

Eligible specialties include:

  • Certified Visual Rehabilitation Therapist (CVRT)
  • Certified Low Vision Therapist (CLVT)
  • Certified Orientation and Mobility Specialists (COMS)
  • Certified Assistive Technology Instructional Specialists (CATIS)

Recipients agree to a minimum 3-year service obligation at a VA facility. The program offers tuition and fees (up to $15,000 per year for full-time students, with caps) and helps build VA’s specialized workforce.

VA Form 10-0491D ensures smooth transition into these specialized roles upon completion.

Step-by-Step Guide to Completing and Submitting VA Form 10-0491D

  1. Complete Education Details — Indicate the degree type (Associate, Baccalaureate, Master’s, Doctorate, or Other) and date conferred.
  2. Attach Required Documents — Official transcript and licensure/certification copies.
  3. Service Obligation Section — Fill the selection details if hired (facility address, position title, hiring official contact, salary, start date) or the update section if seeking placement.
  4. Sign and Date — Participant signature is required.
  5. Submit — Mail to: HPSP/VIOMPSP/VHVMAESP, 1250 Poydras St., Suite 1000, New Orleans, LA 70113.

Submit promptly after graduation to initiate placement. Provide an SF-50 (Notification of Personnel Action) as soon as available for selected positions.

Service Obligation and Placement Process

After completing your program, the VA works to place you in a qualifying full-time position within approximately 90 days. Preferences for location may be considered, but assignments are determined by VA needs.

Failure to complete the service obligation can result in repayment of scholarship funds. The form helps document compliance and any updates or non-selections. Extensions or deferments may be possible in certain circumstances (e.g., via related forms like 10-0491J).

Who Should Use This Form?

  • Current or recent HPSP or VIOMPSP scholarship recipients nearing or at program completion.
  • Students who have fulfilled academic requirements and are preparing for VA employment.
  • VA scholarship program administrators coordinating placements.

U.S. citizens enrolled in accredited programs who meet GPA and other eligibility criteria can benefit from these programs and use this form.

Tips for Successful Submission and Compliance

  • Keep copies of all submissions and communications with the HPSP/VIOMPSP office.
  • Contact [email protected] for questions (Monday–Friday, 8:00 a.m.–5:30 p.m. ET).
  • Monitor official VA channels for updates on application cycles and requirements.
  • Prepare financially for potential relocation, as recipients cover their own moving expenses.

For the most current information, always refer to official VA sources.

Official Resources and Further Reading

This form is part of VA’s commitment to developing a skilled workforce dedicated to serving Veterans. Completing it correctly helps fulfill your service obligation while launching a meaningful career with the VA.

This article is for informational purposes only and is based on publicly available VA resources as of 2026. Consult official VA guidance or the scholarship program office for personalized advice.